Medical students, especially those with little exposure to careers in medicine, have great difficulty imagining a career in medicine other than what they see and experience through their rotations.

Antoinette Moore, 4th-Year Medical Student
And shortly after rotations, they are asked to make choices that place their careers on certain trajectories. And while the scope of someone’s ideal practice will grow and change, the choice of specialty defines us in a way that is undeniably powerful and far reaching into our professional careers.
As I wrap up my third year of medical school, what has become apparent to me is that there are two often unnoticed—and often under-promoted—qualities that influence whether a student chooses one specialty over another.
These two qualities are physical and metaphysical. Physical describes the more brick and mortar/billable procedure/patient population aspects students are exposed to during rotations, such as “Is the preceptorship in a small town or a large urban setting?” and “Does this rotation expose students to a wide variety of patient presentations, procedures, and demographics?” The metaphysical is a bit harder to quantify but importantly demonstrates how happy employees are with their chosen line of work. It speaks to the culture of the rotation environment, which, to the student, serves as a representation of the profession as a whole.